scholarly journals Dietary selenium intake and mortality in two population-based cohort studies of 133 957 Chinese men and women

2016 ◽  
Vol 19 (16) ◽  
pp. 2991-2998 ◽  
Author(s):  
Jiang-Wei Sun ◽  
Xiao-Ou Shu ◽  
Hong-Lan Li ◽  
Wei Zhang ◽  
Jing Gao ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Chinese Populations ◽  
Urban City ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

AbstractObjectiveTo investigate the potential influence of dietary Se intake on mortality among Chinese populations.DesignWe prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women’s Health Study (SWHS) and the Shanghai Men’s Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI.SettingUrban city in China.SubjectsChinese adults (n 133 957).ResultsDuring an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; Ptrend<0·0001) and 0·80 (95 % CI 0·66, 0·98; Ptrend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; Ptrend=0·0001) and 0·66 (95 % CI 0·54, 0·82; Ptrend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses.ConclusionsDietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.

scholarly journals Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study

2018 ◽  
Vol 21 (7) ◽  
pp. 1286-1296 ◽  
Author(s):  
Camilla Plambeck Hansen ◽  
Kim Overvad ◽  
Inge Tetens ◽  
Anne Tjønneland ◽  
Erik Thorlund Parner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Dietary Guidelines ◽  
Health Study ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
National Patient

AbstractObjectiveA direct way to evaluate food-based dietary guidelines is to assess if adherence is associated with development of non-communicable diseases. Thus, the objective was to develop an index to assess adherence to the 2013 Danish food-based dietary guidelines and to investigate the association between adherence to the index and risk of myocardial infarction (MI).DesignPopulation-based cohort study with recruitment of participants in 1993–1997. Information on dietary intake was collected at baseline using an FFQ and an index ranging from 0 to 6 points was created to assess adherence to the 2013 Danish food-based dietary guidelines. MI cases were identified by record linkage to the Danish National Patient Register and the Causes of Death Register. Cox proportional hazards models were used to estimate hazard ratios (HR) of MI.SettingGreater areas of Aarhus and Copenhagen, Denmark.SubjectsMen and women aged 50–64 years (n55 021) from the Diet, Cancer and Health study.ResultsA total of 3046 participants were diagnosed with first-time MI during a median follow-up of 16·9 years. A higher Danish Dietary Guidelines Index score was associated with a lower risk of MI. After adjustment for potential confounders, the hazard of MI was 13 % lower among men with a score of 3–<4 (HR=0·87; 95 % CI 0·78, 0·96) compared with men with a score of <3. The corresponding HR among women was 0·76 (95 % CI 0·63, 0·93).ConclusionsAdherence to the 2013 Danish food-based dietary guidelines was inversely associated with risk of MI.

scholarly journals Visual impairment and risk of dementia in two population-based prospective cohorts: UK Biobank and EPIC-Norfolk

2021 ◽  
Author(s):  
Thomas J Littlejohns ◽  
Shabina Hayat ◽  
Robert Luben ◽  
Carol Brayne ◽  
Megan Conroy ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Uk Biobank ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Promising Target ◽  
Increased Risk

Abstract Visual impairment has emerged as a potential modifiable risk factor for dementia. However, there are a lack of large studies with objective measures of vison and with more than ten years of follow-up. We investigated whether visual impairment is associated with an increased risk of incident dementia in UK Biobank and EPIC-Norfolk. In both cohorts, visual acuity was measured using a “logarithm of the minimum angle of resolution” (LogMAR) chart and categorised as no (≤0.30 LogMAR), mild (&gt;0.3 - ≤0.50 LogMAR), and moderate to severe (&gt;0.50 LogMAR) impairment. Dementia was ascertained through linkage to electronic medical records. After restricting to those aged ≥60 years, without prevalent dementia and with eye measures available, the analytic samples consisted of 62,206 UK Biobank and 7,337 EPIC-Norfolk participants, respectively. In UK Biobank and EPIC-Norfolk. respectively, 1,113 and 517 participants developed dementia over 11 and 15 years of follow-up. Using multivariable cox proportional-hazards models, the hazard ratios for mild and moderate to severe visual impairment were 1.26 (95% Confidence Interval [CI] 0.92-1.72) and 2.16 (95% CI 1.37-3.40), in UK Biobank, and 1.05 (95% CI 0.72-1.53) and 1.93 (95% CI 1.05-3.56) in EPIC-Norfolk, compared to no visual impairment. When excluding participants censored within 5 years of follow-up or with prevalent poor or fair self-reported health, the direction of the associations remained similar for moderate impairment but were not statistically significant. Our findings suggest visual impairment might be a promising target for dementia prevention, however the possibility of reverse causation cannot be excluded.

Abstract 90: Race, Ethnic, and Sex Disparities in Stroke Incidence in the Northern Manhattan Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hannah Gardener ◽  
Ralph L Sacco ◽  
Tatjana Rundek ◽  
Consuelo Mora-McLaughlin ◽  
Ying Kuen Cheung ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Low Socioeconomic Status ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Stroke Incidence ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

Background: An excess incidence of strokes among blacks vs whites has been shown previously, but data on disparities related to Hispanic ethnicity remains limited. This study examines race, ethnic, and sex differences in stroke incidence in the multi-ethnic, yet largely Caribbean Hispanic, Northern Manhattan Study (NOMAS). Methods: The study population included participants in the prospective population-based NOMAS, followed for a mean of 13±7 years. Cox proportional hazards models were constructed to estimate the hazard ratios and 95% confidence intervals (HR, 95%CI) for the association between race/ethnicity and sex with confirmed incident stroke of any subtype and ischemic stroke, stratified by age and adjusting for sociodemographics and vascular risk factors. Results: Among 3,298 participants (mean baseline age 69±10, 37% men, 24% black, 21% white, 52% Hispanic), 477 incident strokes accrued (394 ischemic, 43 ICH, 9 SAH). The most common ischemic subtype was cardioembolic, followed by lacunar infarcts, then cryptogenic. The greatest incidence rate was observed in blacks (13/1000 person-years [PY]), followed by Hispanics (11/1000 PY), and lowest in whites (8/1000 PY), and this order was observed for crude incidence rates until age 75. By age 85 the greatest incidence rate was in Hispanics. Blacks had an increased stroke risk vs whites overall in fully adjusted models (HR=1.37, 95% CI=1.02-1.84), and stratified analyses showed that this disparity was driven by women age ≥70 (HR=1.69, 1.05-2.73). The increased rate of stroke observed for Hispanics (age/sex-adjusted HR=1.50, 1.15-1.94) was largely explained by education and insurance status (a proxy for socieoeconomic status; HR after further adjusting for these variables=1.15, 0.84-1.58), but remained significant for women age ≥70. Men had an increased rate of stroke compared to women (fully adjusted HR=1.48, 1.21-1.81). Conclusions: This study provides novel data regarding the increased stroke risk among Caribbean Hispanics. Results highlight the need to create culturally-tailored campaigns to reach blacks and Hispanic populations to reduce race/ethnic stroke disparities, and support the important role of low socioeconomic status in driving an elevated risk among Caribbean Hispanics.

scholarly journals Colours of fruit and vegetables and 10-year incidence of CHD

2011 ◽  
Vol 106 (10) ◽  
pp. 1562-1569 ◽  
Author(s):  
Linda M. Oude Griep ◽  
W. M. Monique Verschuren ◽  
Daan Kromhout ◽  
Marga C. Ocké ◽  
Johanna M. Geleijnse
Keyword(s):  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Fruit And Vegetables ◽  
Orange Yellow ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Orange Fruit ◽  
Incident Cases

The colours of the edible part of fruit and vegetables indicate the presence of specific micronutrients and phytochemicals. The extent to which fruit and vegetable colour groups contribute to CHD protection is unknown. We therefore examined the associations between fruit and vegetables of different colours and their subgroups and 10-year CHD incidence. We used data from a prospective population-based cohort including 20 069 men and women aged 20–65 years who were enrolled between 1993 and 1997. Participants were free of CVD at baseline and completed a validated 178-item FFQ. Hazard ratios (HR) for the association between green, orange/yellow, red/purple, white fruit and vegetables and their subgroups with CHD were calculated using multivariable Cox proportional hazards models. During 10 years of follow-up, 245 incident cases of CHD were documented. For each 25 g/d increase in the intake of the sum of all four colours of fruit and vegetables, a borderline significant association with incident CHD was found (HR 0·98; 95 % CI 0·97, 1·01). No clear associations were found for the colour groups separately. However, each 25 g/d increase in the intake of deep orange fruit and vegetables was inversely associated with CHD (HR 0·74; 95 % CI 0·55, 1·00). Carrots, their largest contributor (60 %), were associated with a 32 % lower risk of CHD (HR 0·68; 95 % CI 0·48, 0·98). In conclusion, though no clear associations were found for the four colour groups with CHD, a higher intake of deep orange fruit and vegetables and especially carrots may protect against CHD.

Use of disease-modifying antirheumatic drugs and the subsequent risk of herpes zoster in older adults

Rheumatology ◽  
2021 ◽  
Author(s):  
Jiahui Qian ◽  
Marissa Nichole Lassere ◽  
Anita Elizabeth Heywood ◽  
Bette Liu
Keyword(s):  
Herpes Zoster ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Antiviral Therapies ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Using Data ◽  
Subsequent Risk

Abstract Objectives To examine the association between DMARD use and subsequent risk of herpes zoster in a large, heterogeneous, and prospective population-based cohort. Methods Using data from a cohort of adults (45 and Up Study) recruited between 2006 and 2009 and linked to pharmaceutical, hospital and death data (2004–2015), the effect of DMARD use on zoster risk was analysed using Cox proportional hazards models, adjusting for sociodemographic characteristics, comorbidities and corticosteroid use. Results Among 254 065 eligible participants, over 1,826 311 person-years follow-up, there were 6295 new DMARD users and 17 024 incident herpes zoster events. Compared with non-users, the risk of zoster was higher in those who used bDMARDs, either alone or in combination with csDMARDs than in those who only used csDMARDs (adjusted hazard ratios, aHR 2.53 [95% confidence interval, CI 2.03–3.16]) for bDMARDs vs 1.48 [95%CI 1.33–1.66] for csDMARDs, p-heterogeneity &lt; 0.001; reference: non-users). Among users of csDMARDs, compared with non-users, zoster risks were highest in those using exclusively cyclophosphamide (aHR 2.69 [95%CI 1.89–3.83]), more moderate in those using azathioprine (aHR 1.57 [95%CI 1.07–2.30]) and hydroxychloroquine (aHR 1.43 [95%CI 1.11–1.83]) and not elevated in users of methotrexate (aHR 1.24 [95%CI 0.98–1.57]), sulfasalazine (aHR 1.00 [95%CI 0.71–1.42]) and leflunomide (aHR 0.41 [95%CI 0.06–2.88]). Conclusions The risk of zoster was high among bDMARD and cyclophosphamide users. Also, the risk was increased in those using hydroxychloroquine alone and in combination with methotrexate but not methotrexate alone. Preventative strategies such as zoster vaccination or antiviral therapies should be considered in these populations if not contraindicated.

scholarly journals Appendectomy and Non-Typhoidal Salmonella Infection: A Population-Based Matched Cohort Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1466
Author(s):  
Den-Ko Wu ◽  
Kai-Shan Yang ◽  
James Cheng-Chung Wei ◽  
Hei-Tung Yip ◽  
Renin Chang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Research Database ◽  
Cox Proportional Hazards Models ◽  
Increased Risk

The potential association between appendectomy and non-typhoidal Salmonella (NTS) infection has not been elucidated. We hypothesized that appendectomy may be associated with gut vulnerability to NTS. The data were retrospectively collected from the Taiwan National Health Insurance Research Database to describe the incidence rates of NTS infection requiring hospital admission among patients with and without an appendectomy. A total of 208,585 individuals aged ≥18 years with an appendectomy were enrolled from January 2000 to December 2012, and compared with a control group of 208,585 individuals who had never received an appendectomy matched by propensity score (1:1) by index year, age, sex, occupation, and comorbidities. An appendectomy was defined by the International Classification of Diseases, Ninth Revision, Clinical Modification Procedure Codes. The main outcome was patients who were hospitalized for NTS. Cox proportional hazards models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Two sensitivity analyses were conducted for cross-validation. Of the 417,170 participants (215,221 (51.6%) male), 208,585 individuals (50.0%) had an appendectomy, and 112 individuals developed NTS infection requiring hospitalization. In the fully adjusted multivariable Cox proportional hazards regression model, the appendectomy group had an increased risk of NTS infection (adjusted HR (aHR), 1.61; 95% CI, 1.20–2.17). Females and individuals aged 18 to 30 years with a history of appendectomy had a statistically higher risk of NTS than the control group (aHR, 1.92; 95% CI, 1.26–2.93 and aHR, 2.67; 95% CI, 1.41–5.07). In this study, appendectomy was positively associated with subsequent hospitalization for NTS. The mechanism behind this association remains uncertain and needs further studies to clarify the interactions between appendectomy and NTS.

scholarly journals The predictive role of sickness absence spell durations in associations with inpatient- and specialized outpatient care among a population-based Swedish twin sample

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annina Ropponen ◽  
Mo Wang ◽  
Jurgita Narusyte ◽  
Sanna Kärkkäinen ◽  
Victoria Blom ◽  
...  
Keyword(s):  
Patient Care ◽  
Sickness Absence ◽  
Outpatient Care ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Predictive Role

Abstract Background The associations between a sickness absence spell duration and patient care have been rarely studied. An assumption is that associations would differ by spell duration and by the patient care type, inpatient- or specialized outpatient, due to severity of diseases and/or conditions. We aimed to investigate sickness absence spells in various spell durations as a predictor for subsequent inpatient- and specialized outpatient care separately, and to study if familial confounding plays a role in these associations. Methods We followed a population-based sample of Swedish twins born 1925–90 with national registers from 2001 for first incident sickness absence spell (days to calculate spell duration categorized into ≤30 days, 31–90 days, 91–180 days and ≥ 181 days), or no sickness absence, and for inpatient- and specialized outpatient care until 2013 (n = 24,975). Cox proportional hazards models were applied for hazard ratios (HR) with 95% confidence intervals (CI) while accounting for covariates and familial confounding. Results First incident sickness absence spell across all duration categories was associated with an increased risk of inpatient- (age- and sex adjusted HR 1.28 to 6.05) or specialized outpatient care (HR 1.17–2.50), both in comparison to those without any sickness absence or the shortest sickness absence spell category (1–30 days). The associations remained statistically significant while controlling for covariates or familial confounding. Conclusions First incident sickness absence spell increases the risk of inpatient care or specialized outpatient care regardless of the duration of the sickness absence spell. Hence, incident sickness absence spells should be noted and targeted to actions at workplaces as well as in primary and occupational health care.

scholarly journals A Prospective Study of Bisphosphonate Use and Risk of Colorectal Cancer

2012 ◽  
Vol 30 (26) ◽  
pp. 3229-3233 ◽  
Author(s):  
Hamed Khalili ◽  
Edward S. Huang ◽  
Shuji Ogino ◽  
Charles S. Fuchs ◽  
Andrew T. Chan
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Inverse Association ◽  
Cancer Data ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
A Prospective Study

Purpose Bisphosphonates are used for the treatment of bone metastases and have been associated with a lower risk of breast cancer. A recent case-control study showed an inverse association between bisphosphonate use and colorectal cancer. Data from prospective cohorts are lacking. Patients and Methods We prospectively examined the relationship between bisphosphonate use and risk of colorectal cancer among 86,277 women enrolled onto the Nurses Health Study (NHS). Since 1998, participants have returned biennial questionnaires in which they were specifically queried about the regular use of bisphosphonates. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% CIs for risk of colorectal cancer. Results Through 2008, we documented 801 cases of colorectal cancer over 814,406 person-years of follow-up. The age-adjusted HR for women who regularly used bisphosphonates was 0.92 (95% CI, 0.73 to 1.14) and was further attenuated after adjustment for other risk factors (multivariate HR, 1.04; 95% CI, 0.82 to 1.33). The risk was not influenced by duration of use (Ptrend = 0.79). Compared with nonusers, the multivariate-adjusted HRs of colorectal cancer were 1.24 (95% CI, 0.94 to 1.64) for women with 1 to 2 years of use, 1.16 (95% CI, 0.79 to 1.69) for 3 to 4 years of use, and 0.97 (95% CI, 0.60 to 1.56) for ≥ 5 years of use. There was no association between bisphosphonate use and colorectal cancer within strata of other risk factors. Conclusion In a large prospective cohort, we did not observe an association between long-term use of bisphosphonates and risk of colorectal cancer.

scholarly journals Variety in fruit and vegetable consumption and 10-year incidence of CHD and stroke

2012 ◽  
Vol 15 (12) ◽  
pp. 2280-2286 ◽  
Author(s):  
Linda M Oude Griep ◽  
WM Monique Verschuren ◽  
Daan Kromhout ◽  
Marga C Ocké ◽  
Johanna M Geleijnse
Keyword(s):  
Proportional Hazards ◽  
Vegetable Consumption ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Fruit And Vegetable Consumption ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Highly Correlated

AbstractObjectiveConsuming a variety of fruit and vegetables provides many different micronutrients and bioactive compounds. Whether this contributes to the beneficial association between fruit and vegetables and incident CHD and stroke is unknown.DesignProspective population-based cohort study.SettingThe Netherlands.SubjectsMen and women (n 20 069) aged 20–65 years. Participants completed a validated 178-item FFQ, including nine fruit and thirteen vegetable items. Variety in fruit and vegetables was defined as the sum of different items consumed at least once per 2 weeks over the previous year. Hazard ratios (HR) for variety in relation to incident CHD and stroke were calculated using multivariable Cox proportional hazards models additionally adjusted for quantity of fruit and vegetables.ResultsVariety and quantity in fruit and vegetables were highly correlated (r = 0·81). Variety was not associated with total energy intake (r = −0·01) and positively associated with nutrient intakes, particularly vitamin C (r = 0·70). During 10 years of follow-up, 245 cases of CHD and 233 cases of stroke occurred. Variety in vegetables (HR per 2 items = 1·05; 95 % CI 0·94, 1·17) and in fruit (HR per 2 items = 1·00; 95 % CI 0·87, 1·15) were not related to incident CHD. Variety in vegetables (HR per 2 items = 0·93; 95 % CI 0·83, 1·04) and in fruit (HR per 2 items = 1·03; 95 % CI 0·89, 1·18) were also not related to incident stroke.ConclusionsMore variety in fruit and vegetable consumption was associated with higher intakes of fruit and vegetables and micronutrients. Independently of quantity, variety in fruit and vegetables was related neither to incident CHD nor to incident stroke.

scholarly journals Changes in Metabolic Syndrome Status and Breast Cancer Risk: A Nationwide Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1177
Author(s):  
In Young Choi ◽  
Sohyun Chun ◽  
Dong Wook Shin ◽  
Kyungdo Han ◽  
Keun Hye Jeon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Proportional Hazards ◽  
Screening Program ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Health Screening Program ◽  
Design And Methods

Objective: To our knowledge, no studies have yet looked at how the risk of developing breast cancer (BC) varies with changes in metabolic syndrome (MetS) status. This study aimed to investigate the association between changes in MetS and subsequent BC occurrence. Research Design and Methods: We enrolled 930,055 postmenopausal women aged 40–74 years who participated in a biennial National Health Screening Program in 2009–2010 and 2011–2012. Participants were categorized into four groups according to change in MetS status during the two-year interval screening: sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. We calculated multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for BC incidence using the Cox proportional hazards models. Results: At baseline, MetS was associated with a significantly increased risk of BC (aHR 1.11, 95% CI 1.06–1.17) and so were all of its components. The risk of BC increased as the number of the components increased (aHR 1.46, 95% CI 1.26–1.61 for women with all five components). Compared to the sustained non-MetS group, the aHR (95% CI) for BC was 1.11 (1.04–1.19) in the transition to MetS group, 1.05 (0.96–1.14) in the transition to non-MetS group, and 1.18 (1.12–1.25) in the sustained MetS group. Conclusions: Significantly increased BC risk was observed in the sustained MetS and transition to MetS groups. These findings are clinically meaningful in that efforts to recover from MetS may lead to reduced risk of BC.

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